| Author |
LASIK for high myopia
|
|
| Robert Kopp 2005-09-24, 2:39 pm |
| In general, results are not as satisfactory for LASIK correction of high
myopia as with lesser degrees. I've heard treatment of -14 D described as
foolish, and some even consider -8 D a little high, considering other
treatment options now available (phakic IOL). In general, what is the upper
limit for reasonable assurance of success with LASIK?
--
Robert T. Kopp
http://analytic.tripod.com
| |
| ycdbsoya 2005-09-24, 2:39 pm |
| -14 would be very high, but Tiger Woods was a -12 I believe and he had
great results. -8 is doable but is also a high number, and there are
numerous risk factors that come into play the higher the refractive
error. You cannot look at the refractive error number without
considering other factors such as pupil size, age, corneal depth,
stromal depth, propensity for vitreous floaters/detachments, tear
quality viz-a-viz severed corneal nerves, etc.
There is no upper limit for the reasonable assurance of success in
LASIK. A -2 will have a much better chance to see 20/20 with no/little
side effects than a -8, but the same set of risks are present with
every procedure, with some variation in the SD of the risk.
The best thing to do if you're considering RS is to determine who the
top 3-4 docs are, and make an apporinment. Traingulate your way to the
decision based on the facts you recieve and a smidgeon of "gut feeling."
| |
| CatmanX 2005-09-24, 2:39 pm |
| -14 is rather high with the trade off being a small optic zone and
prone to glare haloes and the rest of the problems associated with it.
Phakic IOL or refractive lensectomy are the wiser options at that
level.
drgrant
| |
| Glenn - USAEyes.org 2005-09-24, 2:39 pm |
| A primary limiting factor for myopic (nearsighted, shortsighted)
higher refractive error correction is corneal thickness.
For each diopter of correction, about 12 microns of corneal tissue
must be removed during LASIK. This ratio of tissue removal to diopter
correction becomes greater with a larger treatment area to accommodate
large pupils, and for wavefront-guided laser ablation. The LASIK flap
will be at least 100 microns thick, up to about 160 microns. A minimum
of 250 microns of cornea must remain untouched for a healthy cornea to
remain stable.
Adding the 250 microns needed for stability, the 100-160 microns for
the LASIK flap, and 12-20 microns of tissue removal for each diopter
of correction would require an unusually thick cornea or compromises
that are better left alone.
For a high myope under age 40, a phakic intraocular lens (P-IOL)
should be investigated. For a high myope over age 40, refractive lens
exchange (RLE) may be the appropriate option.
Or the best option may simply be using contacts and glasses.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Ragnar 2005-09-24, 2:39 pm |
| Tiger Woods was -11D and is now seeing 20/15 and is well on his way
to winning more major PGA events than any golfer ever. Is that
enough?
Phakic IOLs? eek... horrible idea unless you are over 60. It should
be illegal to do phakic IOLs on anybody under 40. Look up
"accomodation"
On Tue, 6 Sep 2005 11:38:11 -0700, "Robert Kopp" <koppr@hevanet.com>
wrote:
>In general, results are not as satisfactory for LASIK correction of high
>myopia as with lesser degrees. I've heard treatment of -14 D described as
>foolish, and some even consider -8 D a little high, considering other
>treatment options now available (phakic IOL). In general, what is the upper
>limit for reasonable assurance of success with LASIK?
| |
| Robert Kopp 2005-09-24, 2:39 pm |
|
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:49kvh1118dtei70rf3hot1vd6hcc8cvk02@4ax.com...
> Tiger Woods was -11D and is now seeing 20/15 and is well on his way
> to winning more major PGA events than any golfer ever. Is that
> enough?
I met a friend at a picnic yesterday. He was -12 D before LASIK in 2001, and
appears to be satisfied with the results.
> Phakic IOLs? eek... horrible idea unless you are over 60. It should
> be illegal to do phakic IOLs on anybody under 40. Look up
> "accomodation"
>
I think this should be left to the discretion of the practitioner. If a
patient has trouble accommodating, the solution may be found in Wal-Mart's
variety section.
--
Robert T. Kopp
http://analytic.tripod.com
| |
| Ragnar 2005-09-24, 2:39 pm |
| IOLs are not really an alternative to LASIK, they are an "instead of"
IOLs are for people who for some reason can't have lasik or for people
with cataracts or at an age where they are likely to have cataracts
soon or for people who lack any type of accomodation. My current
advice would be to not consider IOLs until after 50. And before 40,
someone better have a real good reason for getting IOLs.
On Thu, 8 Sep 2005 09:57:11 -0700, "Robert Kopp" <koppr@hevanet.com>
wrote:
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:49kvh1118dtei70rf3hot1vd6hcc8cvk02@4ax.com...
>
>I met a friend at a picnic yesterday. He was -12 D before LASIK in 2001, and
>appears to be satisfied with the results.
>
>I think this should be left to the discretion of the practitioner. If a
>patient has trouble accommodating, the solution may be found in Wal-Mart's
>variety section.
| |
| CatmanX 2005-09-24, 2:40 pm |
| Robert, what is your age? I recently sent a patient for refractive lens
exchange who was 45 and -7.50 script. The surgeon agreed that RLE was
the preferred option to Lasik and now with ReZoom MF implants she wears
no specs and sits in her Law office on the computer all day with no ill
effects.
The downside of Lasik is the larger the script, the smaller the
ablation zone, so more chance of problems and the need for multiple
surgeries increases significantly. Most of the surgeons I deal with are
not overly willing to perform Lasik over -7.00 because of the reduced
success rate, ie. haloes, reduced vision quality etc.
If you are interested in options, go see a good surgeon and see what
they have to say about it.
dr grant
| |
| mnprescott 2005-09-24, 2:40 pm |
| There is no reasonable assurance for success with LASIK.
"Robert Kopp" <koppr@hevanet.com> wrote in message
news:11hroga5us767a5@corp.supernews.com...
> In general, results are not as satisfactory for LASIK correction of high
> myopia as with lesser degrees. I've heard treatment of -14 D described as
> foolish, and some even consider -8 D a little high, considering other
> treatment options now available (phakic IOL). In general, what is the
> upper limit for reasonable assurance of success with LASIK?
>
>
> --
> Robert T. Kopp
> http://analytic.tripod.com
>
| |
| serebel 2005-09-24, 2:40 pm |
| Now there's a blanket statement. What side of the fence is mnpreccott
on? Hmmmm.
SErebel
| |
| Ragnar 2005-09-24, 2:40 pm |
| That ranks as one of the top 10 most absurd comments ever made in this
newsgroup.
The predictability and success for LASIK is higher than any other
surgery procedure.
On Thu, 8 Sep 2005 21:50:23 -0400, "mnprescott" <mnprescott@aol.com>
wrote:
>There is no reasonable assurance for success with LASIK.
>
>
>"Robert Kopp" <koppr@hevanet.com> wrote in message
>news:11hroga5us767a5@corp.supernews.com...
>
| |
| Robert Kopp 2005-09-24, 2:40 pm |
|
"CatmanX" <grantm@connexus.net.au> wrote in message
news:1126215724.388525.243940@o13g2000cwo.googlegroups.com...
> Robert, what is your age? I recently sent a patient for refractive lens
> exchange who was 45 and -7.50 script. The surgeon agreed that RLE was
> the preferred option to Lasik and now with ReZoom MF implants she wears
> no specs and sits in her Law office on the computer all day with no ill
> effects.
I'm 57. Actually, my questions about LASIK are mainly to get information for
friends. I've had bilateral cataract extraction with about -1 D remaining
refraction in each eye. LASIK is a possibility, but I'm not sure it's worth
the trouble, given the fact that I need glasses for reading anyhow.
| |
| Graeme Hewson 2005-09-24, 2:40 pm |
| On Fri, 09 Sep 2005 10:16:21 GMT, ragnarsuomi@yahoo.com (Ragnar) wrote:
> The predictability and success for LASIK is higher than any other
> surgery procedure.
What are your references?
| |
| CatmanX 2005-09-24, 2:40 pm |
| For your friends, the comments stil count. I will assume they are of
similar age to you. RLE still remains the best option and eliminates
the need for glasses in many cases. With Lasik there is always going to
be some compromise, whether monovision and loss of binocularity or
distance correction and the need to wear readers.
dr grant
| |
| CatmanX 2005-09-24, 2:40 pm |
| Cliff does not need references, he is a law unto himself.
grant
| |
| Ragnar 2005-09-24, 2:40 pm |
| That is Grant's way of saying "If Ragnar says something, it is true".
All the references in the world don't mean anything to someone who
doesn't understand what the references mean. Here's an example of how
references can be misused.
There might be an article that says "10 million people have been
treated with lasik successfully, however one patient died during
surgery when the roof of the lasik facility caved in". Then some
looney would come along and post a message saying "Lasik patient dies
during surgery!"
On 9 Sep 2005 13:01:12 -0700, "CatmanX" <grantm@connexus.net.au>
wrote:
>Cliff does not need references, he is a law unto himself.
>
>grant
| |
| Graeme Hewson 2005-09-24, 2:40 pm |
| That looks to me as though you're dodging my question.
| |
| journal article 2005-09-24, 2:40 pm |
| Yes, but Tiger wants to bow out of tournaments as soon as the sun starts to
set. His night vision... with 11D of myopia correction and conventional
LASIK has GOT to be absolute trash. He has a contractual commitment with TLC
not to complain about it, certainly.
11D of myopia correction would eat a great deal of corneal tissue. His
corneas must be very thin... wonder if he'll have problems with ectasia some
day. Or perhaps he has problems now with blurry vision if the pillow touches
his eyelid when he sleeps.... like Serebel. Wonder if he has to wear
permanent plastic plugs in his tear ductc because of nerve damage from LASIK
like Serebel.
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:49kvh1118dtei70rf3hot1vd6hcc8cvk02@4ax.com...[vbcol=seagreen]
> Tiger Woods was -11D and is now seeing 20/15 and is well on his way
> to winning more major PGA events than any golfer ever. Is that
> enough?
> Phakic IOLs? eek... horrible idea unless you are over 60. It should
> be illegal to do phakic IOLs on anybody under 40. Look up
> "accomodation"
>
> On Tue, 6 Sep 2005 11:38:11 -0700, "Robert Kopp" <koppr@hevanet.com>
> wrote:
>
| |
| journal article 2005-09-24, 2:40 pm |
| Glenn, Ragnar and Serebel never back up anything they say with peer-reviewed
literature
references. They just make stuff up.
"Graeme Hewson" <ghewson@cix.co.REVERSE:ku> wrote in message
news:memo.20050909201407.2639A@cix.compulink.co.uk...
> On Fri, 09 Sep 2005 10:16:21 GMT, ragnarsuomi@yahoo.com (Ragnar) wrote:
>
>
> What are your references?
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| If you were to remove that 1.00 diopter of residual myopia
(nearsighted, shortsighted) vision you would find an increased need
for reading glasses. It may be more reasonable to investigate
monovision correction
(http://www.usaeyes.org/faq/subjects/monovision.htm) or just leave
well enough alone.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| Hanson, why don't you just use your name instead of a different alias
every few days?
So now you are going to tell us that Tiger Woods - the world's best at
a sport that demands excellent vision - has vision that is "absolute
trash". Isn't interesting how a zealot knows more about the vision
quality of the people who had LASIK than the people who had LASIK.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| Hanson, you have never pointed out any statement I have made that is
factually inaccurate, nor have you found anything on our website that
is factually inaccurate. I have on many occasions provided references
to back up my statements.
You, of all people, accusing me of making stuff up is absurdity
squared.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| serebel 2005-09-24, 2:40 pm |
| Hell, Hanson's even diagnosing me !!! My post lasik eyes are in great
shape yet he keeps on posting that my eyes are a disaster. What an
utter fool.
SErebel
| |
| Ragnar 2005-09-24, 2:40 pm |
| Tiger wants to bow out of tournaments as soon as the sun starts to
set? I am not aware of any golf tournament that has ever gone into
sunset.
On Sat, 10 Sep 2005 16:16:40 -0400, "journal article" <journal
article@aol.com> wrote:
>Yes, but Tiger wants to bow out of tournaments as soon as the sun starts to
>set. His night vision... with 11D of myopia correction and conventional
>LASIK has GOT to be absolute trash. He has a contractual commitment with TLC
>not to complain about it, certainly.
>
>11D of myopia correction would eat a great deal of corneal tissue. His
>corneas must be very thin... wonder if he'll have problems with ectasia some
>day. Or perhaps he has problems now with blurry vision if the pillow touches
>his eyelid when he sleeps.... like Serebel. Wonder if he has to wear
>permanent plastic plugs in his tear ductc because of nerve damage from LASIK
>like Serebel.
>
>
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:49kvh1118dtei70rf3hot1vd6hcc8cvk02@4ax.com...
>
| |
| Robert Kopp 2005-09-24, 2:40 pm |
|
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:910ai11j5kedj1b2hfhqpvno7aog2vopjf@4ax.com...
> Tiger wants to bow out of tournaments as soon as the sun starts to
> set? I am not aware of any golf tournament that has ever gone into
> sunset.
>
I would think that baseball would be one of the sports most demanding of
good vision. An outfielder probably doesn't get a good look at the ball
until the last instant, and many games are played at night. If some lased
individuals are baseball players, this would be a good testimonial.
--
Robert T. Kopp
http://analytic.tripod.com
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| Not only is LASIK very popular with professional baseball players, but
many consider a player with LASIKed vision as "cheating". Some compare
LASIK to the use of steroids because it can provide such a competitive
advantage.
See http://slate.msn.com/id/2116858/
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| CatmanX 2005-09-24, 2:40 pm |
| How do you figure that one out Glenn? Admittedly, most baseballers are
drug cheats in a sport too gutless to take control, but how is Lasik of
any advantage over contacts for the majority, other than some ophthal
will do it for free???
dr grant
| |
| serebel 2005-09-24, 2:40 pm |
|
CatmanX wrote:
> How do you figure that one out Glenn? Admittedly, most baseballers are
> drug cheats in a sport too gutless to take control, but how is Lasik of
> any advantage over contacts for the majority, other than some ophthal
> will do it for free???
>
> dr grant
Lasik has been a boon for baseball players. Greg Maddux, Bernie
Williams, etc. by not dusting up their lenses.
SErebel
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| That's not my opinion, that is the opinion voiced by others (see the
link).
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| CatmanX 2005-09-24, 2:40 pm |
| Interesting article. Full of more crap than Ragnar. Lasik modifies
shape to give what every one else has, not more. It can not give better
acuity than you are already capable of, not yet anyway.
grant
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| Probably not to the same degree as you, but I agree that the article
was a bit thick on the hype.
The most LASIK is able to do is provide vision equal to the best
vision you had with corrective lenses. In some cases, vision after
today's LASIK is actually better than vision before LASIK, but that is
neither common nor predictable.
This article makes it appear that athletes are getting "supervision",
which is generally not the case. There are most certainly some
advantages to having excellent uncorrected vision vs. excellent
corrected vision, but "supervision" is not one of them.
At least the article did point out that not everyone gets the result
they desire and that risk is still a factor.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| CatmanX 2005-09-24, 2:40 pm |
| Certainly agreed Glenn. Eventually, Lasik will probably give better
that able to be corrected by glasses or current CL technology, but
still that will be only to the extent that the eye is capable of being
corrected. THen again it will more likely be a Lasek or PRK derivative
that will deliver that sort of acuity, but it certainly is feasible
that as laser optical design technology improves, wavefront design will
be incorporated along with the topography of the eye to create a close
to perfect optical curve.
By the way, wht does baseball turn such a blind eye to drug cheats???
Down here, the AFL (our major football code ) was forced into the WADA
drug testing guidelines by withdrawal of all government funding to
grassroot foootball (about $500 million over the next 190 years) unless
it complied. The AFL had already agreed to a watered down code with the
players association which with not test for recreational drugs (dope,
Ecstasy etc) outside of competition season. The government said not
acceptable. MBL is virtually supporting steroid use by its stance
against drug testing, or at least that is how it seems from over here.
grant
| |
| Glenn - USAEyes.org 2005-09-24, 2:40 pm |
| Off Topic.
I really don't know why professional baseball has been so lenient
regarding steroid and similar enhancement drug use, but my opinion is
that it all boils down to money.
Players who play better get bigger contracts. Players who make big
plays bring in more fans to the ballpark and put more butts in front
of the TV. Team owners make a lot of money off those tickets, TV
rights, advertising, and trademark. Everyone had an incentive to let
this happen, and so it was all a wink-wink, nudge-nudge.
Now that the elephant is in the dining room, nobody seems really sure
how to get him out without knocking down the whole house.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| ycdbsoya 2005-09-24, 2:40 pm |
| You yourself said that your corneas crumple easily and you have dry
eyes as a result of RS. I guess there's nothing wrong with your eyes,
now is there? What a case.
|
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